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Improving psychiatric diagnosis in multidisciplinary child and adolescent mental health services

  • Daniel Michelson (a1), Stephen Rock (a1), Sophia Holliday (a2), Gil Myers (a3), Susan Tilki (a4), Elizabeth Murphy (a2) and Crispin Day (a1) (a2)...
Abstract
Aims and method

We examined learning outcomes, practice impacts and implementation processes for a training intervention in diagnostic skills delivered to multidisciplinary child and adolescent mental health service practitioners (n = 63).

Results

Training was viewed positively by most participants and associated with significant increases in practitioner self-efficacy, with the effect sustained at 8-month follow-up. A comparative audit before and after training indicated that clinicians were significantly more likely to assign an Axis I diagnosis following the training intervention. However, absolute rates of Axis I classification remained relatively low (< 40%) both before and after training. Practitioners were moderately successful at following through on personal plans for implementing new learning; inconsistent support for implementation was provided within teams.

Clinical implications

A brief training workshop may have limited effects in changing practitioners' behaviour so that diagnoses are made more promptly and appropriately recorded. Future workforce development initiatives should consider more comprehensive and diversified strategies, including targeted post-training support, if increased self-efficacy following training is to be translated into sustained changes in diagnostic practice.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Daniel Michelson (daniel.michelson@iop.kcl.ac.uk)
Footnotes
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Declaration of interest

None.

Footnotes
References
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1 Department of Children, Schools and Families. Children and Young People in Mind: The Final Report of the National CAMHS Review. Department of Children, Schools and Families, 2009.
2 Jensen-Doss, A, Weisz, JR. Diagnostic agreement predicts treatment process and outcomes in youth mental health clinics. J Consult Clin Psychol 2008; 76: 711–22.
3 Bentham, GHH, Heg, RR, Van Leeuwen, YD, Metsemakers, JFM. Teaching psychiatric diagnostics to general practitioners: educational methods and their perceived efficacy. Med Teach 2009; 31: 279–86.
4 Royal College of Psychiatrists and National Institute for Mental Health in England. New Ways of Working for Psychiatrists: Enhancing Effective, Person-centred Services through New Ways of Working in Multidisciplinary and Multi-agency Contexts. Department of Health, 2005.
5 World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. WHO, 1992.
6 Davis, JR, Rawana, EP, Capponi, DR. Acceptability of behavioral staff management techniques. Behav Resident Treat 1989; 4: 2344.
7 Janssen-Noordman, A, Merriënboer, JJG, van der Vleuten, CPM, Scherpbier, AJJA. Design of integrated practice for learning professional competences. Med Teach 2006; 28: 447–52.
8 Garb, H. Clinical judgment and decision making. Annu Rev Clin Psychol 2005; 1: 6789.
9 Samuel, DB, Widiger, TA. Comparative gender biases in models of personality disorder. Personal Ment Health 2009; 3: 1225.
10 Whaley, AL, Geller, PA. Toward a cognitive process model of ethnic/racial biases in clinical judgment. Rev Gen Psychol 2007; 11: 7596.
11 de Lusignan, S, Wells, SE, Hague, NJ, Thiru, K. Managers see the problems associated with coding clinical data as a technical issue whilst clinicians also see cultural barriers. Methods Inf Med 2003; 42: 416–22.
12 Oxman, AD, Thomson, MA, Davis, DA, Haynes, RB. No magic bullets: a systematic review of 102 trials of interventions to improve professional practice. CMAJ 1995; 153: 1423–31.
13 Sholomskas, DE, Syracuse-Siewert, G, Rounsaville, BJ, Ball, SA, Nuro, KF, Carroll, KM. We don't train in vain: a dissemination trial of three strategies of training clinicians in cognitive-behavioral therapy. J Consult Clin Psychol 2005; 73: 106–15.
14 Bennett-Levy, J, Beedie, A. The ups and downs of cognitive therapy training: what happens to trainees' perception of their competence during a cognitive therapy training course? Behav Cogn Psychother 2007; 35: 6175.
15 Perkins, M, Jensen, P, Jaccard, J, Gollwitzer, P, Oettingen, G. Applying theory-driven approaches to understanding and modifying clinician behavior: what do we know? Psychiatr Serv 2007; 58: 342–8.
16 Fischbacher, C, Chappel, D, Edwards, R, Summerton, N. Health surveys via the internet: quick and dirty or rapid and robust? J R Soc Med 2000; 93: 356–9.
17 Goodman, R, Ford, T, Richards, H, Gatward, R, Meltzer, H. The Development and Well-Being Assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. J Child Psychol Psychiatry 2000; 41: 645–55.
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BJPsych Bulletin
  • ISSN: 1758-3209
  • EISSN: 1758-3217
  • URL: /core/journals/bjpsych-bulletin
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Improving psychiatric diagnosis in multidisciplinary child and adolescent mental health services

  • Daniel Michelson (a1), Stephen Rock (a1), Sophia Holliday (a2), Gil Myers (a3), Susan Tilki (a4), Elizabeth Murphy (a2) and Crispin Day (a1) (a2)...
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